Organization
EAST CENTRAL HEALTH DISTRICT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DAISY LOUISE FERGUSON (LPN)
(706) 667-4282
Entity
Organization
Contact information
Practice address
2401 CRYSTAL CT, AUGUSTA, GA 30906
(706) 790-3485
Mailing address
2401 CRYSTAL CT, AUGUSTA, GA 30906-5615
(706) 790-3485
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
LPN039414
GA
Other
Enumeration date
01/17/2007
Last updated
08/22/2020
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